Juniper House

Juniper House is a nursing home providing personal and nursing care for up to 60 older people, some of whom were living with dementia. The care home accommodates people over 2 floors in 1 adapted building. At the time of the inspection there were 55 people living at the service.

People's experience of using this service and what we found

Risks to people's safety were assessed and care plans were in place to guide staff regarding the support people needed.

People and their relatives spoke positively about the care and support they received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Safe recruitment processes were followed to ensure people were supported by staff who had the appropriate experience and were of good character. There were enough staff, and they were deployed effectively to provide people with appropriate support.

Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe. There were safe systems in place and people received their medicines when required.

Infection and prevention control processes were in place to support the prevention and spread of infection.

The service had a positive ethos and an open culture. The management team were approachable, understood the needs of people, and listened to staff. People that used the service and their relatives had the opportunity to feedback on the quality of the support and care provided. There were effective systems in place to monitor the quality of the service and drive improvements.

The management and staff team worked in partnership with others including health professionals and commissioners.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Juniper House provides accommodation and care for up to 60 older people, including people that need support because of their physical frailty and those who need professional nursing care because of their medical condition. Additionally the ‘Memory Lane’ section of the home specialises in supporting people living with dementia. Respite care and short breaks are part of the service provided at Juniper House. The home is purpose built and adapted throughout to meet the diverse care needs of the people in residence. There were 59 people in residence when we inspected the service on 24 and 30 November 2017.

At the last inspection on 21 August 2015 the service was rated ‘Good’. At this unannounced inspection we found the service remained ‘Good’.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social care Act 2008 and associated regulations about how the service is run.

People were safe. People were protected by robust recruitment procedures that made sure people did not receive unsafe care from staff that were unsuited to the job. They were safeguarded from avoidable harm and poor practice by staff that knew what action they needed to take if they suspected this was happening.

People were cared for by sufficient numbers of professional nurses and care staff. People's needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. They received care from staff that had received training and support to carry out their roles.

The premises and equipment used to provide people with the care they needed were appropriately maintained throughout to ensure their safety. Systems were in place to ensure the premises was kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.

People received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. They were treated equally and their individuality was respected by staff.

Risks to people’s safety were reviewed as their needs and dependencies changed. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe.

People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups. Medicines were appropriately and safely managed. Medicines were securely stored and there were suitable arrangements in place for their timely administration by the nurse in charge.

People enjoyed their meals and said they always had enough to eat and drink. Individuals who needed encouragement and support with eating a healthy diet received the help they required.

The provider and registered manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all people using the service. Staff had insight into people’s capabilities and aspirations. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive. Their individual preferences for the way they liked to receive their care and support were respected.

The rating from our previous inspection was prominently displayed in the foyer of the home. The provider also ensured that this rating was appropriately displayed on their website.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that there had been an improvement in the way that the accidents and incidents were recorded. We found that there was sufficient information recorded about injuries sustained in accidents to inform medical staff of injuries incurred in accidents.

We found that people's needs had been assessed and risks to people's health and wellbeing had been identified and control measures put in place.

We found that the staff at Juniper House managed the medicines and the quality monitoring of the home well. We saw that staff were recruited appropriately and there were enough staff to meet the needs of the people who used the service.

We found concerns with the way staff monitored people's health following an accident.

We found that there were some processes in place to ensure the safe use of medicines. However we found that the controlled drugs were not stored in line with regulations. We also saw that that not all medicine records were complete.